28 statements
· 1 topic
· summaries given as host listed separately
Featured statements
▶Ep 5 · 23:03
the surgeon will remember that one single case where they had a delay because their patient was given fluids within the hour. Um it should be rare if you've got a good system, um but if you actually have good data to show them how it's actually working, a lot of the times you can get people on board
the typical tactics that we use within that are things like um optimizing fluid and analgesia, mobilizing early, feeding early. And these all get bundled up so they act synergistically
quotethose of you who've been doing work in um adult general surgical care uh will be relatively familiar with enhanced recovery after surgery and uh I think this is kind of expanding and increasing in the pediatric surgical world↗
▶Ep 5 · 0:23
clinicalERAS is relatively familiar in adult general surgical care↗
▶Ep 5 · 0:23
opinionMary Brindell and Kurt Heist have been pediatric ERAS ambassadors, though this is changing as ERAS expands in pediatric surgery↗
▶Ep 5 · 15:40
clinicalEnhanced recovery after surgery is a multidisciplinary, multimodal, evidence-based way of delivering care to patients↗
▶Ep 5 · 15:40
clinicalThe goals of ERAS are to optimize patient physiology throughout the entire perioperative pathway↗
▶Ep 5 · 15:40
clinicalERAS strategies are to decrease operative trauma, inflammatory response, and stress↗
▶Ep 5 · 15:40
clinicalTypical ERAS tactics include optimizing fluid and analgesia, mobilizing early, and feeding early, which act synergistically when bundled↗
▶Ep 5 · 15:40
opinionThe whole of ERAS is greater than the sum of its parts↗
▶Ep 5 · 15:40
clinicalERAS outcomes include faster healing, earlier discharge, and fewer complications↗
▶Ep 5 · 15:40
quoteenhanced recovery after surgery is multidisciplinary, multimodal, evidence-based way of delivering care to patients↗
▶Ep 5 · 15:40
clinicalFast track surgery programs have shown reduced length of stay after surgery↗
▶Ep 5 · 15:40
clinicalA concern with fast track programs has been increased readmission rates, but ERAS's holistic approach should decrease readmission rates when done well↗
▶Ep 5 · 15:40
quotethe outcomes are that they heal faster, they go home earlier, they have fewer complications↗
▶Ep 5 · 15:40
quotethe typical tactics that we use within that are things like um optimizing fluid and analgesia, mobilizing early, feeding early. And these all get bundled up so they act synergistically↗
▶Ep 5 · 15:40
quoteThe strategies are to decrease um operative trauma, inflammatory response and stress↗
▶Ep 5 · 15:40
clinicalThe adult world has a huge amount published on the benefits of ERAS, including decreased surgical and non-surgical complications↗
▶Ep 5 · 15:40
quotethe goals are to optimize patient physiology throughout the entire perioperative pathway↗
▶Ep 5 · 15:40
quoteone of the important things about enhanced recovery after surgery is that the whole of it is greater than the sum of their parts↗
▶Ep 5 · 18:53
opinionThere is no way a surgeon can use ERAS without all the other disciplines being on board and doing ERAS↗
▶Ep 5 · 20:39
quotethere's no way that I can use ERS with all without all those other people↗
▶Ep 5 · 23:03
quoteyes it does require you to be a champion but you absolutely cannot do this alone. No matter how much passion you have for enhanced recovery after surgery, it has to be a team sport↗
▶Ep 5 · 23:03
quotethe surgeon will remember that one single case where they had a delay because their patient was given fluids within the hour. Um it should be rare if you've got a good system, um but if you actually have good data to show them how it's actually working, a lot of the times you can get people on board↗
▶Ep 5 · 25:54
quotewe often feel like we're we're doing uh the right thing by our patients um and that our practices are good, but there's a lot between us uh knowing that we should be doing something and that patient actually receiving um that treatment↗
▶Ep 5 · 28:49
quoteonce you start having teams that get invested in this, um they naturally want to start adopting other elements of enhanced recovery after surgery care↗
▶Ep 5 · 28:49
opinionIt is exceptionally hard to limit ERAS practice to the subset of patients for which it was initially intended↗
▶Ep 5 · 28:49
opinionOnce teams get invested in ERAS, they naturally want to start adopting other elements of enhanced recovery after surgery care↗
▶Ep 5 · 28:49
quoteit is exceptionally hard to limit this type of uh practice to the subset of patients for which you initially intended to use it↗
▶Ep 5 · 28:49
clinicalThe neonatal intestinal surgery ERAS protocol was published earlier in 2024↗
Summaries Mary gave as host
· 6 summaries
Recaps of other experts' statements, not Mary's own clinical position.
Summaries Mary gave as host · Crohn's Disease6 summaries
host summaryMary Brindell summarizes what Dr. Kurt Heist said: over the course of years with um additional ERS elements that were adopted, um additional work for implementation that there's decreased interoperative fluids that are given, decreased uh intraoperative and post-operative narcotics, decrease time to um getting on a full diet↗
▶Ep 5 · 23:03
host summaryMary Brindell summarizes what Dr. Kurt Heist said: A study by Kurt, Mulan, and team at Emory showed that over years with additional ERAS elements adopted, there were decreased intraoperative fluids, decreased intraoperative and postoperative narcotics, and decreased time to getting on a full diet↗
▶Ep 5 · 28:16
host summaryMary Brindell summarizes what Dr. Kurt Heist said: there is a uh paper and publication in JPS right now on dudal Treachery repairs and enhanced recovery that shows that they uh have an excellent uh return rate, recovery rate and without a increased return rate↗
▶Ep 5 · 28:16
host summaryMary Brindell summarizes what Dr. Kurt Heist said: We began to use enhanced recovery in our newborns um and found that the uh kids with motility problems like an imperforate anus, um all the other enhanced recovery principles worked well, but feeding them immediately was not a great idea↗
▶Ep 5 · 28:16
host summaryMary Brindell summarizes what Dr. Kurt Heist said: There is a paper in publication in JPS on duodenal atresia repairs and enhanced recovery showing excellent recovery rate without increased return rate↗
▶Ep 5 · 28:16
host summaryMary Brindell summarizes what Dr. Kurt Heist said: ERAS in newborns works well for most principles, but feeding immediately is not a great idea for kids with motility problems like imperforate anus↗
